Cord Blood Albumin and Bilirubin as Predictor of Neonatal Jaundice

Abstract

Background: Jaundice in newborn is quite common affecting nearly 60% of term and 80% of preterm neonates during the first 7 days of life. It is the most common cause of readmission in the hospital during early neonatal period. Aims: To find out the sensitivity of cord blood bilirubin and albumin level in predicting neonatal hyperbilirubinemia in healthy newborn. Material and Methods: The study was conducted on 200 full term healthy babies delivered by LSCS and were followed up till day 3 of life. 2ml of blood was drawn for estimating albumin and bilirubin in a sterile manner from the umbilical cord & then veni puncture at 72 hrs of life from those neonates for estimation of bilirubin. All these samples were taken to the laboratory immediately. Results: from 200 babies, 53 babies developed significant hyperbilirubinemia (>15mg/dl) with incidence of 26.5%. The mean weight of these babies was 2.47±0.38kg, mean cord blood bilirubin was 2.83±0.44mg/dl, mean cord albumin was 2.64±0.3 gm/dl and mean total serum bilirubin after 72 hrs of life was 17.31±2.09mg/dl. Cord blood bilirubin >2.5mg/dl had a sensitivity of 90.5% and specificity 90.4% in the development of hyperbilirubinemia and had a direct correlation, wherever cord blood albumin <2.8gm/dl has sensitivity 86.0% and specificity of 93% and showing an inverse correlation. Conclusion: Neonates with cord blood bilirubin <2. 5mg.dl and cord blood albumin >2.8 can be safely discharged early whereas neonates with bilirubin >2.5gm/dl and cord blood albumin <2.8g/dl will need close follow up for development of significant hyperbilirubinemia. Keywords: Hyperbilirubinemia, cord blood, bilirubin, albumin